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Ottobock-Cuba: A new era in orthopedic technology

Hospital ortopedicoThe collaborative alliance between Cuba and the German company Ottobock has allowed for access to knowledge and the transfer of technology, with the purpose of improving the quality of life of Cuban patients via orthopedic technology.

This was stated by Mileydys Salermo Torres, resident in the eastern province of Holguín, who received a prosthesis for her right leg, as one of the first 13 beneficiaries of the “Cuba in Motion” project, initiated in 2016 and sponsored by the German firm and the Ministry of Public Health (Minsap).

“In 1999, when my leg was amputated, I came to the capital for them to make a prosthesis for me. With that one, I always used crutches to support myself and had a lot of difficulty adapting to walking with the apparatus. A year ago, I heard about the German collaboration. They evaluated my case and today I received this dynamic leg, lighter and more flexible,” the table tennis national champion told Granma International.

Likewise, Caridad Kañeri Miranda, from the municipality of Güines in Artemisa, and Juan Antonio Araujo Turro, from Pinar del Río, are being evaluated to receive prostheses in 2019, among a group of 20 patients. Araujo lost his upper and lower extremities in an electrical accident.

Argentine Marcelo Cuscuna, Ottobock regional representative in Latin America, explained that the Cuba in Motion concept addresses two areas: the implanting of orthopedic prosthesis and the modernization of orthopedic technology workshops, including the training of professionals in the use of the company’s technology.

“One of our company’s principal objectives has been to continue and reaffirm the connection with Cuba, as one of our pilot projects, which has witnessed the growth of a nation with an emerging economy, but with sustainable development. This connection dates back many years,” Cuscuna explained, describing a shared history.

Ottobock was born in 1919 to serve those injured during WWI, an idea proposed by professor Otto Bock, an orthopedic technician. The company grew rapidly, extending its productions to include comfortable wheelchairs and orthopedic devices, accessories suggested by doctors to correct posture, deformations, and injuries with back straps, elastic knee and ankle bands, among others.

The company established ties with Cuba in the 1970s and 80s, via an exchange with the German Democratic Republic, which supplied machinery and managed workshops and laboratories known by Cubans as “Cuba-RDA.”

Ottobock’s Chief Executive, Hans Georg Näder, visited the island in 2014 and was amazed to see equipment that had been in use for more than 30 years, still working well and providing solutions to Cuban patients’ challenges. He therefore decided to make a first donation of some 500,000 euros to modernize an orthopedics technology workshop functioning in a Cuba-RDA laboratory, in the Havana neighborhood of Miramar.

“We are consolidating here the production of several prostheses and orthoses. The response of the Cuban government has been positive, both in the case of Minsap (Ministry of Public Health) and several enterprises like Medicuba, and the National Center for Orthopedic Technology (CNOT), with the intention of expanding our horizons in prostheses to all Cuban provinces,” Cuscuna stated.

Agreeing with him is Cuban engineer Héctor E. Corcho Morales, Ottobock manager in Cuba. He emphasized that the principal attraction leading to the establishment of ties was the prestige, the human dimension, and ethical values of Cuban professionals, capable of transforming knowledge and taking full advantage of the capacity of existing equipment to provide medical coverage for 100% of the population.

“In this company, tradition and progress are not contradictory, but rather strongly united. While we explore new markets and targeted groups, and develop novel technologies at an increasingly faster rate, there is something that remains immutable: our work is always focused on people. We intend to have patients participating in society, regardless of the degree of their disabilities,” Corcho Morales explained.

Likewise, German Thomas Pfleghar, responsible for the evaluations of Cuban patients selected to receive Ottobock prosthesis, acknowledged that he is excited to work alongside Cuban technicians, saying, “These youth do very good work, show great interest in learning, and one does not get tired of the activity.”

Ortho-prosthesis technician, Alejandro Vidal Pérez-Delgado, was chosen along with three other co-workers to travel to Germany and participate in a 10-month training program sponsored by the German international cooperation society

Deutsche Gesellschaft für Internationale Zusammenarbeit, and to share his learning with colleagues upon returning to Cuba.

“The course was presented in English and we were awarded international certification,” the young man said, adding that working in this area of rehabilitation is about getting people to smile again, explaining, “We get discouraged patients, with no desire to continue their life projects. I offer all my knowledge so they have faith and continue their social lives, despite their limitations.”

His co-worker Yamir Bacallao Remú is getting ready for a similar one-month course in Brazil. He began working in the shop as a helper in 1993, and by 2000 had earned a university degree. He evaluates patients’ physical characteristics, makes their prostheses, delivers and repairs the devices if necessary, since they may wear out with use.

“Before the German equipment arrived in the workshop, we made devices without much metric precision. They were crafted without specialized machinery, by sight. We measured with a plumb line or a string with a magnet in our hands. Now we have a laser that takes more exact measurements and helps us align the prosthesis. Those made now are of greater quality because the equipment helps,” Bacallao explained, adding that he received training from his co-workers who studied in Germany.

CNOT director Geovani Suárez Fernández commented on these trainings, saying that as part of the Cuba in Motion project, the German firm has designed four courses, which have already been offered to 60 professionals in Havana. Another two will be presented during November and December, including one to provide training in techniques being used in developed countries.

He pointed out that, along with this training, plans include the modernization of machinery in prosthesis workshops across the country. Labs in Santiago de Cuba, Villa Clara, and Camagüey, are ready to receive new equipment, along with the bandaging department in Havana.

“The world is advancing a great deal in regards to orthopedic technology. There are prostheses with many features. Patients walk much easier, are self-sufficient, they place less strain on their bodies, which translates to less fatigue,” the doctor emphasized, a General Medicine specialist, who has also studied enterprise management.

Some 1,600 prostheses are crafted in Cuba every year, and the incorporation of new equipment has favored the reduction of energy consumption and production costs. Moreover, since the devices are a better fit, they last longer and require fewer repairs.

Foreign patients have the opportunity to acquire these novel types of prosthesis, and many other orthopedic devices, via the Cuban medical services state enterprise, SMC, or while receiving treatment at a Cuban institution. Cuba offers collaboration in this field in Uruguay and Haiti.

In a brief history, Luis Hernández Mazorra, one of the workers with the longest careers in the workshop, recounted that the Cuba-RDA labs were first opened in 1965, when a donation was received from Germany to support production of orthopedic devices.

The idea emerged during the first trip to Germany of injured Cuban combatants who participated in the guerilla war in the Sierra Maestra, in Playa Girón, and the struggle against counterrevolutionary bandits in the Escambray. They traveled to receive rehabilitation and some were inspired to study associated professions. This was how the first orthopedic technicians and professors were trained.

Once the equipment arrived, it was installed in a house in Miramar, located at 32nd Street and 7th Avenue.

Grouped within the CNOT, which provides methodological advice, workshops now exist in 15 provinces, although in Havana alone, more than 10,000 services in different specialties are provided every month, and more than 100,000 treatments annually, including those to acquire orthopedic shoes.

For the director of the Cuba-RDA lab in the capital, the academic preparation is essential because it allows for training of all technicians at a national level. Very few countries have conceived this type of profession, with a university degree program available at the University of Medical Sciences’ School of Health Sciences and Technology.

Speaking of his experience, he said, “This profession is my life. I believe I spend more time in the workshop than in my own home. I arrive at 6:30 am and leave after six in the evening. I pass by over the weekend and on holidays. I feel good when patients express their satisfaction with being able to participate in social life. Even their families thank us and recognize us anyplace we may be. People treat us with much respect and affection.”


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